2015-2016 REGISTRATION FORM
ST. DOMINIC CATHOLIC SCHOOL
18105 West Capitol Drive, Brookfield, WI 53045
262-783-7565
Office Use Only:
Date Received_________________
Payment Received______________
St. Dominic Catholic School will accept registrations and deposits at any time. Registration forms will be marked with the date
and time received starting on December 8, 2014. Parish family registrations are given first priority over non-parish family
registrations. Please see the New Student Admission policy in the event that multiple forms are received at the same time.
Turning in the registration form does not guarantee admission to St. Dominic Catholic Parish School.
Fee and Tuition Deposit-All new families will be charged a $100 nonrefundable registration fee, plus a $140 tuition deposit
which will be applied to your September tuition payment. This $240 non-refundable payment per family will be paid at the time
of registration. If your child is put on a Waiting List, your deposit can be returned to you with notification of your child’s
Waiting List status.
PLEASE SUBMIT A COPY OF BAPTISMAL CERTIFICATE FOR EACH CHILD WITH REGISTRATION FORM
Family Last Name
Home Phone Number ________________________
Email Address (Print Clearly)___________________________________________
Father or Guardian ____________________________________________________________________________________
Last
First
Middle
Address ______________________________________________________________________________________________
Street
City
Zip Code
Occupation
Religion__________________ Work Phone Number(
) ________________
Cell Phone (______)__________________
Mother or Guardian ____________________________________________________________________________________
Last
First
Middle
Address ______________________________________________________________________________________________
Street
City
Zip Code
Occupation __________________________ Religion ___________________Work Phone Number(____)___________
Cell Phone (______)__________________
(INCOMING STUDENTS MUST BE OF AGE BY SEPTEMBER 1,2015)
Name of Child
Date of
Place of Birth
Grade to enter
Sacraments Received?
(list oldest child first)
Birth
Sept. 2015
Last Name
First
Middle
City
State (For K3, K4, please Baptism Eucharist Reconciliation
indicate preference)
Name
Name
Health Limitations (Allergies, etc.) – please also identify name of child with limitations
_________________________________________________________________
Please continue on the reverse side.
If K3 Please indicate preference (1 being highest priority) - ___ T,Th AM ___ MWF AM ___ 5-Day Afternoon
If K4 Circle Preference Morning Afternoon
*Class assignments are based on the Admission Policy, not preference
Name of School child(ren) last attended _______________________________________________
Address of School last attended
City & State
Zip Code
Please indicate if there are other children in the family attending schools other than St. Dominic Catholic School.
Name of Child
School Name
Grade Entering
(list oldest child first)
as of Sept. 2015
Last Name
First Name
“STUDENT ADMISSION POLICY: The school does not discriminate on the basis of race, color, national
origin, ethnicity, gender or disability in the administration of its admissions policy. The school admits students of
any race, color, national origin, and ethnicity as all are recognized as children of God. The final decision for
admission, instruction, and retention of any student rests with the principal or pastor.
The following priorities will be used to determine admissions to full classes at St. Dominic Catholic School.
Children who are presently enrolled as of the present school year. This priority will be forfeited if the children
leave school.
2. Children of families with siblings currently enrolled in St. Dominic Catholic School who are active, registered
parish members.
3. Children whose parents/guardians are active, registered St. Dominic Parish members. Enrollment priority for
this group will be based on the following order:
a. Those on the present year’s waiting list and who have requested consideration for the coming year
b. St. Dominic Catholic School Registration Form receipt date
c. St. Dominic Parish enrollment date
4. Children of St. Dominic Catholic School teachers and other parish staff members.
Children whose parents/guardians are not registered St. Dominic P
5. arish members in the following priority order:
a. Families who were on the present year’s waiting list and request consideration for the coming year
b. Families of other Catholic parishes
c. Families of other religious affiliations
1.
The administration will give careful consideration to the admission of students with special needs in keeping with
its mission to teach every student about Jesus Christ and the Catholic faith and its traditions while building a
strong foundation of academic excellence, but is not required to enroll, re-enroll or continue the enrollment of
students whose needs cannot be met with reasonable accommodations.”
Extended Care is available for K3 through grade 8. Extended Care hours are 7:00 A.M. – 5:45 P.M.
[ ] - I would like information about Extended Care